中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (5): 476-482.doi: 10.19438/j.cjoms.2025.05.008

• 论著 • 上一篇    下一篇

舌下神经袢转位修复腮腺肿瘤术后面神经缺损的可行性研究

叶启程, 卢浩, 徐万林, 刘胜文, 杨雯君, 张陈平   

  1. 上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2024-11-18 修回日期:2025-02-04 发布日期:2025-10-10
  • 通讯作者: 刘胜文,E-mail: wubenzhimu17@163.com
  • 作者简介:叶启程(2001-),男,博士研究生,E-mail: 3225371503@qq.com
  • 基金资助:
    上海市“科技创新行动计划”医学创新研究专项(22Y11903300)

Descending branch of hypoglossal nerve-facial nerve transfer: a novel effective technique for facial nerve defects after parotid gland tumor resection

Ye Qicheng, Lu Hao, Xu Wanlin, Liu Shengwen, Yang Wenjun, Zhang Chenping   

  1. Department of Oromaxillofacia Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; School of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Medical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2024-11-18 Revised:2025-02-04 Published:2025-10-10

摘要: 目的: 探讨舌下神经袢转位修复腮腺肿瘤术后面神经缺损的临床效果。方法: 对2例累及面神经的腮腺肿瘤患者,根据面神经缺损情况,术中同期行舌下神经袢-面神经分支端端吻合,并采用House-Brackmann(H-B)评级量表、Terzis微笑功能评级量表和口角静态对称性评级量表,评估面神经功能恢复情况。结果: 2例患者均采用单纯舌下神经袢转位修复面神经缺损,1例修复面神经颧支、颊支缺损;另1例修复面神经下颊支、下颌缘支缺损。术后随访发现,2例患者面神经功能恢复良好,均未出现舌运动偏斜、肌肉萎缩症状,且言语和吞咽功能正常。结论: 采用舌下神经袢转位修复面神经缺损简单、有效,为腮腺肿瘤术后的复杂面神经缺损修复重建提供了新的临床策略。

关键词: 舌下神经袢, 面神经缺损, 腮腺肿瘤, 面瘫, 修复重建

Abstract: PURPOSE: To investigate the clinical outcome of descending branch of hypoglossal nerve-facial nerve transfer for facial nerve defects after parotid gland tumor resection. METHODS: Two patients with facial nerve defects after parotid tumor resection underwent descending branch of hypoglossal nerve-facial nerve transfer. The House-Brackmann (H-B) scale, Terzis scale and Symmetry scale of oral commissure were used to assess the facial nerve function. RESULTS: The descending branch of hypoglossal nerve-facial nerve transfer was performed in two patients, for the facial nerve defects after parotid tumor resection. The descending branches of hypoglossal nerve were directly transfered to the zygomatic branch and buccal branches in one patient, while the inferior buccal branch and marginal branch for the other. Follow-up results revealed that two patients had good recovery of facial nerve functions, with no symptoms of tongue movement deviation or muscle atrophy. And the patients' speech and swallowing functions were quite normal. CONCLUSIONS: Descending branch of hypoglossal nerve-facial nerve transfer is an effective technique, which can be performed simply and easily. This technique provides a novel clinical strategy for functional reconstruction of complex facial nerve defects after parotid tumor surgery.

Key words: Descending branch of hypoglossal nerve, Facial nerve defect, Parotid gland tumor, Facial palsy, Reconstruction

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